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MAR-23-2011 11:37 Service Station Systems 408 938 8888 P.05 <br /> 10 40 <br /> Monitoring System Certification-Page 3 of 3 <br /> Site Address: 401 W. Kettleman Ln. Date:of Testing/SeMcing: 2/23/11 <br /> E. in-Tank Gauging/SIR Equipment: 0 Cheek this box if tank gauging is used only for inventory control. <br /> ❑ Check this box if no tank gauging or SIR equipment is installed. <br /> This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. <br /> Com lug checklist; <br /> 0 Yes R No* Has all input wiring been inspected for proper entry and termination,including testing for ground faults'? <br /> ❑ Yes 0 No* Were all tank gauging probes visually inspected for damage and residue buildup? <br /> 0 Yes 0 No* Was accuracy of system product level readings tested? <br /> 13 Yes ❑ No* Was accuracy of system water level readings tested? <br /> ❑ yes ❑ No* Were all probes reinstalled properly? <br /> 0 Yes Q No* Were all items on the equipment manufacturers maintenance checklist completed! <br /> *in Section H below,describe how and when these deficiencies were or will be corrected. <br /> G. Line Leak Detectors(LLD): 0 Check this box if LLO's are not installed. <br /> Cum lets the folio ng checklist: <br /> 3 Yes 0 No* For equipment start-up or annual equipment certification was a leak simulated to verify LLD performance? <br /> ❑ N/A (Check all that apply) Simulated leak rate: 0 3 g.p.h.(l.); ❑ 0.1 g.p.h.(2.); D 0.2 g.p.h.(2.). <br /> Notes: 1. Required for equipment start-up certification and annual certification. <br /> 2. Unless mandated bX local agency,certification required only for electronic LLD start-u . <br /> C1 Yes 0 No* Were all LLD's confirmed o erational and accurate within regulatory r uirements? <br /> r❑ <br /> I3 Yes 13 No* Was the testing apparatus ro crl calibrated'? <br /> � Yes 0 No* For mechanical LLD's,does the LLD restrict product flow if it detects a leak? <br /> 0 N/A <br /> Yes ® No* For electronic LLD's,does the turbine automatically shut off if the LLD detects a leak? <br /> N N/A <br /> Q Yes ❑ No* For electronic LLD's,docs the turbine automatically shut off if any portion of the monitoring system is disabled <br /> M N/A or disconnected? <br /> 0 Yes 0 No* For electronic LLD's,does the turbine automatically shut off if any portion of the monitoring system <br /> W N/A malfunctions or fails a test? <br /> Llyy13No* for electronic LLD's,have all accessible wiring connections been visually inspected'? <br /> 9 N/A <br /> (3 No* Were all items on the equipment manufacturer's maintenance checklist completed? <br /> *In Section H below,describe how and when these deficiencies were or will be corrected. <br /> H. Comments: LLD Tester that was used during initial testing(passed)on 2/23/11 did not have a Calibration Sticker. <br /> Returned on 3/18/11(Bryan Lundien)and retested all LLD's(passed) <br />